Adventures in Medicaid 1 & 2

Google Maps leads her to a haunted house that’s recently been through a tornado. This can’t possibly be the doctor’s office. The patient calls the number. “No, you’re in the right place,” says the receptionist. “We’re in the basement.” The patient opens the iron gate and the hinges fall off in fragments. A small piece of paper is taped to the exterior of the Brooklyn brownstone. “OB-GYN THIS WAY.”

The waiting room is reassuring. It feels vaguely medical, perhaps due to all the fashion magazines. But it is not somewhere that the patient wants to remain for two hours. Two hours later the doctor summons her into a cramped, dusty office. The walls are mostly comprised of narrow closets. The patient wonders what’s in those closets. The patient suspects it might be human skeletons. The doctor tells the patient that she can’t trust her own boyfriend not to give her AIDS. The doctor tells the patient that if she wants to have viable offspring she should probably get pregnant by mid-afternoon. Then the doctor leads her into a dimly lit exam room. It’s a challenge to navigate the exam room without knocking into the rusty metal tables that hold the doctor’s instruments. The patient drops her bra on the tile floor. When she retrieves her undergarment, she must disentangle it from a sizable hairball of diverse DNA.

“Now what have we here?” says the doctor during her vaginal safari. “Is this your uterus?” She pokes around with animated perplexity. “No, I think this is your uterus. Unless your uterus is anteverted.”

“It’s not,” says the patient.

“Then what on earth could this be? Oh! Maybe it’s my finger. You’re skinny so I could be feeling my finger.” The patient wonders if her vagina is so cavernous that fingers can be misplaced in it. “I’m going to send you to diagnostics for an ultrasound.”

“Do I have cancer?” asks the patient.

“It’s probably just my finger,” says the doctor. “But you can never be too sure.”

2

The patient takes the F train to Brighton Beach. The air smells like Atlantic Ocean and dryer exhaust. After a fifteen-minute walk, the patient locates the psychiatrist’s office. It has a steep, sharply pointed roof and the patient wonders if a witch lives there. The sign on the window says, “ATTN PATIENTS THIS OFFICE NOT CONTAIN NARCOTIC DRUGS.” The Russian receptionists are friendly as can be. The patient fills out her paperwork and takes a seat. The patient deduces from a chorus of grumbles that the other three people in the waiting room have been there for over an hour. More patients arrive every few minutes. Each time someone enters or exits the office, the two exterior doors slam shut violently. When the patient hears this sound, all of her muscles seize up and she feels that something bad is about to happen. The psychiatric traffic continues to increase.

One man has clearly lost command over his grey beard and his overall personal hygiene. His mind seems to be in mutiny as well. He paces back and forth in the waiting room, demanding to see the doctor. “I’ve been here for fifteen hours!” he shouts. He has been there for five minutes. He’d taken the patient’s chair while she was in the restroom. A heavily tattooed woman enters the office wearing a swimsuit and cover-up. She looks as if she’s been tanning all day, every day, buttressed by a bank of mirrors, since April.

“I’m a walk-in,” she says over the counter. “How long is the wait?”

“An hour,” says the receptionist. “There are four patients ahead of you.”

“You can ask them,” says the receptionist. The woman turns to face the crowded room like an actress under the glow of a spotlight that can only adore her.

“Would it be all right with everyone if I go first?” she says. “I’ve got my baby with me.” A couple maternal-looking Russian ladies shrug their shoulders. “Thank you so much!” gushes the woman. “I’ll only be with the doctor for like two minutes. In and out.” She leaves the office. The doors explode in her wake. Through the window, the patient sees the woman and her partner smoking cigarettes over a baby stroller. Her partner has a teardrop tattoo under one eye, indicating that he probably killed someone in jail. The patient is annoyed.

A lady in a floral housedress sits down next to her. A lap dog pants erratically in the folds of her skirt. The lady soon starts up a conversation with the receptionist at the opposite end of the room. “Are you going to watch the Republican debates tonight?” she asks.

“Donald Trump might be a little obnoxious,” says the lady in the housedress, stroking her unstable dog, “but look at all he’s accomplished. He must be doing something right to have made all that money. You have to be pretty smart and resilient to come back from so many bankruptcies.” The patient texts her boyfriend furiously.

The tattooed beach bunny and her partner return to the waiting room with the child they made together. After ramming the stroller into a table from several different angles, causing In Style magazines to rain down upon the rug, the family settles in the corner. The woman turns to the patient and asks her point-blank if she can go ahead of her. The patient seems to be the final barrier between the woman and her shameless line jumping. The patient huffily consents. Shortly thereafter a receptionist summons the woman into the doctor’s office, where the woman remains for 20 minutes.

During this interlude the baby wakes up and the father removes him from the stroller. He sings and coos to his son with an exemplary amount of tenderness. And the baby is hands-down the cutest baby the patient has ever seen. The new parents are probably feeling overwhelmed, but they’re doing the best they can, and it’s understandable that they’d need to get their meds an hour before everyone else. The patient regrets being such a raging bitch about the line jumping.

When it’s finally the patient’s turn with the doctor, she’s already established a tentatively low opinion of him based on the fluctuating sea of poor mental health that constitutes his waiting room. She sits down in a stained leather armchair and tries not to read the names on the medical charts stacked messily across his desk. The office is relatively quiet, and the doctor seems sane enough. He begins her evaluation. First some easy questions: age, marital status, history of drug abuse. Then he begins alternating the easy questions with bizarre questions, as if trying to throw her off.

“What do you think of homosexuality?” he says. “Is the money in your wallet sequentially arranged?” Meanwhile the patient can hear a new male voice through the office door. The voice seems to be berating the receptionists about something. They ask him to please settle down. He becomes louder and more belligerent. The doctor seems utterly disinterested in all the waiting room drama. The patient wishes that he would hurry up and fill out her prescriptions so the angry man and his pathological brethren in the waiting room can have their turn and stop freaking the fuck out. The exterior doors begin slamming again. The patient’s nerves are popping like blown fuses. She imagines guns, cops, homicidal rampages. “If you found a stamped envelope on the street,” asks the doctor, “what would you do with it?”

At the end of his interrogation, the doctor peers closely at the patient. “I don’t think you have […],” he says. “I think you have generalized anxiety disorder.”

In the interest of concluding this interview with maximum grace and celerity, the patient does not respond, “Who the fuck wouldn’t develop generalized anxiety disorder after spending an hour in your medical establishment?” She takes the prescriptions, shakes the doctor’s placid hand, and departs through the waiting room, trying not to think about all the eyes burning through her back, especially the dog’s.

“Generalized anxiety disorder my ass,” the patient thinks, while wondering if any psychiatric patients are following her to the Neptune Avenue F station. She sprints up the stairs to the Manhattan-bound platform. After a few stops her crowded train car empties out. “What the hell does he know?” the patient thinks as she slowly inches away from a woman on her plastic bench because she thinks that the woman doesn’t want her to sit so close to her now that there’s more space, but the patient also doesn’t want to hurt the woman’s feelings by making her think that she doesn’t want to sit so close to her. Even though it’s been driving the patient up the goddamn wall that the two of them are still sitting so close together.

“That appointment was horseshit,” the patient thinks as she walks down 7th Avenue behind a cluster of people that includes a teenage boy wearing headphones. The boy disregards a red pedestrian light and steps out in front of a car. “Watch out!” she screams. The driver of the car lays on his horn. The boy does not get hit. “I should have done more,” the patient thinks. “I should have leapt forward and pulled the boy out of harm’s way. I should have thrown myself into traffic and used my body as an organic barrier. The boy could have been killed and it would have been my fault.” The patient stops at the next intersection and a man taps her on the shoulder.

“You just saved that kid’s life,” he says. “He should’ve at least said thank you.”

“Oh no,” the patient sputters. “I didn’t do anything. I think he just heard the car horn.” The patient walks the rest of the way home worrying that she’d mishandled the exchange with the man. He’d just been trying to make a point about the boy’s ingratitude, not her heroics. So it had been narcissistic of her to steer his observation back toward herself.

“What a charlatan,” she thinks, mouth dry and hands twitching. “That psychiatrist needs to go back to medical school.”